What is Scar Revision

Scar revision is a procedure to reduce, remove, or improve a scar.

A scar is your body’s way of healing an injury. Scars may be caused by surgery, cuts, scrapes, burns, or a skin disease such as acne. Scars can change the appearance of your skin if they are wide, raised, sunken, or discolored.

A scar near your eye or lip may change the appearance of your face. A scar may also cause your skin to tighten, which can restrict movement.

What are the different techniques for scar revision?

Several techniques can be used for scar revision. Your health care provider may use more than one technique. The technique that is used will depend on the size, location, and type of scar you have.

Some techniques require anesthesia. You may be given one or more of the following:

• A medicine to help you relax (sedative).
• A medicine to numb the area (local anesthetic).
• A medicine to make you fall asleep (general anesthetic).

Common techniques for scar revision include injections, surface techniques, and surgical scar removal.

Injections

• A protein solution (collagen) may be used to fill sunken scars. The results may last several months or a few years.
• A steroid injection may be used to shrink raised scars.

Surface Techniques

These techniques reduce scars by removing the top layers of scar tissue. Options include:

• Dermabrasion. This involves a mechanical sanding away of scar tissue.
• Laser resurfacing. Focused light is used to remove scar tissue.
• Chemical peel. A chemical is used to remove scar tissue.
• Bleaching. A chemical is used to lighten scar tissue that is dark or red.

Surgical Scar Removal

These procedures involve cutting out the scar and closing the skin to create a smaller, less visible scar. Types include:

• Scar excision. This involves removing the scar and closing the skin in layers. The skin is closed using fine stitches (sutures), glue, or tape.
• Scar excision with a skin flap. The scar is removed, and the skin is closed using a flap of your skin. Normal skin near the scar is lifted and moved into the area where the scar was removed.
• Scar excision with a skin graft. The scar is removed, and a skin graft is used to close the area of removal. The graft may come from another area of your skin, a donor, or a skin substitute.
• Tissue expansion. This involves placing a balloon under or near the scar. The balloon is gradually blown up to stretch the skin. After your skin is stretched, your scar can be removed, and the stretched skin can be used to close the incision.

What are the risks and benefits?

The main benefit of scar revision is a better look for your skin. You also may have freer movement if you had a tight scar.

Risks of the procedure may include:

• Bleeding.
• Bleeding under the skin (hematoma).
• Infection.
• Allergic reactions to medicines.
• Numbness.
• Pain.
• Damage to nerves or blood vessels.
• Changes in skin color.
• A need for more revision.

Your scar may not be completely gone after a revision procedure. Talk with your health care provider about what to expect.

How should I take care of my scar after the procedure?

Follow all instructions from your health care provider. These may vary depending on the type of procedure that you had. Be aware that it is normal to have some swelling, discomfort, and redness for a week or two. Healing may take several weeks or months. Full healing may take up to a year.

Follow these general instructions after any type of scar revision:

• Do not drive for 24 hours if you received a sedative.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• If directed, apply a cold compress to the scar area to relieve swelling, itching, or discomfort.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid activities that stretch the skin area where your scar was treated.
• Avoid exposing the scar revision area to the sun. Ask your health care provider if you should use a sunscreen lotion.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. They can slow healing. If you need help quitting, ask your health care provider.
• Use over-the-counter and prescription medicines, creams, or ointments only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

After a surgical scar removal, you may be given these additional instructions:

• Keep the bandage (dressing) dry until your health care provider says it can be removed.
• Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
• Change your dressing as told by your health care provider.
• Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

When should I seek medical care?

Seek medical care if:

• You have a fever.
• You have signs of infection.
• You have bleeding or fresh bruising.
• You have numbness.
• You have increasing pain.